Ann Rehabil Med.  2017 Jun;41(3):434-440. 10.5535/arm.2017.41.3.434.

Development of a Dysphagia Screening Test for Preterm Infants (DST-PI)

• Lee KM
• Seo YT

• KMID: 2389459
• DOI: http://doi.org/10.5535/arm.2017.41.3.434

Abstract

OBJECTIVE
To explore both the early prediction and diagnosis of dysphagia in preterm infants as an important developmental aspect as well as the prevention of respiratory complications, we developed the simple and-easy-to-apply Dysphagia Screening Test for Preterm Infants (DST-PI) to predict supraglottic penetration and subglottic aspiration.
METHODS
Fifty-two infants were enrolled in a videofluoroscopic swallowing study (VFSS) due to clinical suspicions of dysphagia. Thirteen items related to supraglottic penetration or subglottic aspiration were initially selected from previous studies for the DST-PI. Finally, 7 items were determined by linear logistic regression analysis. Cutoff values, sensitivity, specificity, and the area under the ROC curve (AUC) of the DST-PI for predicting supraglottic penetration or subglottic aspiration were calculated using a ROC curve. For inter-rater reliability, the kappa coefficient was calculated.
RESULTS
Seven items were selected: "˜gestational age,'"˜history of apnea,'"˜history of cyanosis during feeding,'"˜swallowing pattern,'"˜coughs during or after feeding,'"˜decreased oxygen saturation within 3 minutes of feeding,' and "˜voice change after feeding.' The Spearman correlation coefficient between the DST-PI and the penetration-aspiration scale (PAS) was 0.807 (p<0.001). The sensitivity and specificity at different cutoff values for detecting supraglottic penetration and subglottic aspiration were 96.6% and 76.9% at 3.25, and 88.9% and 75.8% at 6.25, respectively.
CONCLUSION
The DST-PI is a valid and reliable dysphagia screening test for supraglottic penetration or subglottic aspiration in preterm infants that is easy to apply in a clinical context.

Keyword

Dysphagia; Premature infant; Screening test; Videofluoroscopic swallowing study; Aspiration

MeSH Terms

Cyanosis
Deglutition
Deglutition Disorders*
Diagnosis
Humans
Infant
Infant, Newborn
Infant, Premature*
Logistic Models
Mass Screening*
Oxygen
ROC Curve
Sensitivity and Specificity
Oxygen

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